[All the bodies of anorexia]. / Tous les corps de l'anorexie.

Anorexia is an active struggle against hunger. In this fight, the body is a real battlefield where the therapies used aim to re-establish peace. Hence the importance of an integrative 'body to body' approach between patient and caregiver.

[My stomach, the monster under my bed]. / Mon ventre, ce monstre caché sous mon lit.

Care for patients with eating disorders is complex and plurimodal. Care plans need to be adapted in order to take into account the body in crisis. A series of hospital admissions combined with specific psychomotor approaches, can contribute to the patient being reappropriated with their own body.

[Treating the somatic complications of anorexia]. / Traiter les complications somatiques de l'anorexie.

Anorexia can cause serious somatic complications, linked to undernutrition or associated pathological behaviours. The care pathway drawn up by a multi-discipline team is a real therapeutic challenge. Oral nutritional supplements, enteral nutrition and parenteral nutrition are three possible forms of nutritional assistance.

[Anorexia and borderline personality disorder : bonds pathology]. / Anorexie mentale et trouble borderline : une pathologie du lien.

Comorbidity with a borderline personality disorder is far from rare in patients suffering from eating disorders. Clinically, this presents as chronic instability in many areas: interpersonal relationships, self-image, emotions, mood and acting out. Treatment is mainly based on a containing and reassuring therapeutic framework. A care plan may be put in place that incorporates reducing impulsive harmful, eating and self-harming behaviours. Dialectical behaviour therapy is intended in particular to prevent suicide risk in borderline personality disorder patients.

Binge eating behavior among a cohort of normal weight college women.

BACKGROUND AND PURPOSE: Binge eating (BE) has been linked to the development of eating disorders and obesity, and it has been reported in college women. Few studies investigate BE by weight category. The purpose of this study was to examine BE in "normal" weight college women. METHODS: Secondary analysis of Web-based survey at a private university in the northeastern United States. RESULTS: Sample was 317 female subjects, 75.4% were White. Binge eating was reported by 99 women (31.2%); 7.6% of binge eaters were underweight, 73.5% normal weight, 15.3% overweight, and 4.1% obese. Normal weight binge eaters were more likely to purge (x = 6.830; p = .033) and overexercise (x = 15.179, p = .019). All binge eaters reported feeling sad, guilty, or distressed after eating and weight dissatisfaction. Normal weight binge eaters reported negative affect before (x = 33.187; p < .001) and after eating (x = 36.329; p < .001) more frequently than normal weight non-binge eaters. Normal weight binge eaters more often described themselves as overweight when compared with normal weight non-binge eaters (x = 9.267; p = .026). IMPLICATIONS FOR PRACTICE: Nearly one third of college women report BE, the majority are of normal weight. These women are more likely to engage in compensatory mechanisms and have distorted body image and a negative affective state with eating. Findings highlight the importance of screening for BE in college women regardless of weight.

Caring for patients who have eating disorders.

This article gives an overview of the nurse's role when caring for patients with eating disorders. While mental health nurses are more likely than general nurses to be dealing with patients with eating disorders, such disorders can influence an individual's ability to recover from other illnesses so knowledge of this area is relevant in all settings.

Nursing Care Considerations for the Hospitalized Patient with an Eating Disorder.

Eating disorders are chronic psychiatric illnesses with significant medical complications, psychological distress, and psychiatric comorbidity. Although many patients are treated on an outpatient basis, inpatient care for the more severely ill hospitalized patient can be challenging given the severity of illness and concurrent issues requiring intervention. This article provides an overview of the clinical characteristics of eating disorders typically seen for inpatient care, focusing primarily on anorexia nervosa and bulimia nervosa, and the associated key areas for nursing assessment, diagnoses, and plan of care during hospitalization.

Understanding bulimia and its implications in pregnancy.

Bulimia is a serious eating disorder that affects up to 19% of women in the United States. Research shows that bulimia may present a threat to the normal course of pregnancy. Nursing can play an important role in the prevention of maternal and neonatal morbidity through the early detection of bulimia. Bulimia and its impact on pregnancy are described to assist nurses in the early detection and referral of women with this disorder.

Primary care of adolescents with bulimia nervosa.

Adolescents with bulimia nervosa present a challenge to pediatric nurse practitioners. These adolescents have a disorder that is secretive and difficult to diagnose, chronic, multifaceted, and difficult to treat. However, armed with the proper knowledge and skills, pediatric nurse practitioners are the ideal primary health care providers for this population.

Thin line: managing care for adolescents with anorexia and bulimia.

Anorexia nervosa ranks third among common chronic disorders in adolescents, surpassed only by asthma and obesity. Unfortunately, recent changes in health care and insurance have resulted in fewer resources for these vulnerable clients Anorexia and bulimia are best managed by a treatment team, but frequently it is the nurse who manages much of the eating-disordered client's care, especially when there is no available team, or when the nurse is the primary care provider or therapist. Nurses can and do care for adolescents with anorexia and bulimia. All it takes is commitment, knowledge, and networking.

The role of the nurse practitioner in the diagnosis and management of bulimia nervosa, Part 1: Diagnosis.

Bulimia nervosa is a complex syndrome that is usually difficult to diagnose and treat. Its secretive nature and minimal physical symptoms impede detection, while its chronicity impedes management. As a primary care provider, the nurse practitioner must be able to assess and intervene with these challenging clients. This series of articles will allow the nurse practitioner to develop a foundation for caring for clients with bulimia nervosa.

The role of the nurse practitioner in the diagnosis and management of bulimia nervosa, Part 2: Physiologic management.

Physiologic management of bulimia nervosa is targeted primarily toward restoration and maintenance of nutrition and prevention and treatment of complications. The intensity, frequency, and duration of care depend on the severity of the disorder. Some form of physiologic management is recommended while the client is in psychotherapy. The client should be monitored for the possibility of hospitalization. Consistent management will allow for better health care.

The role of the nurse practitioner in the diagnosis and management of bulimia nervosa, Part 3: Psychosocial management.

Psychological problems associated with bulimia nervosa affect both the client and the family. The nurse practitioner is often in a position to refer the client to a therapist who has experience in treating clients with eating disorders. The nurse practitioner and the therapist, along with the nutritionist, if available, need to work from the beginning as a team. Each team member must have a distinct role regarding management of specific aspects of client care in order to avoid confusion and attempted manipulation by the client.

Caring for the hospitalized patient with an eating disorder.

Effective nursing care for hospitalized patients with anorexia nervosa or bulimia nervosa is based on a comprehensive assessment, including medical and treatment history, mental status, and core eating disorder symptoms. Although most patients with an eating disorder are treated in an outpatient setting, hospitalization is appropriate for patients experiencing severe malnutrition or comorbidity or who are at increased risk for medical instability. Inpatient nursing care is directed at optimizing health status, including focused interventions directed at improving nutrition, cognition, coping, and medical stability.

Multisystem complications of bulimia: a critical care case.

Bulimia is an eating disorder characterized by behaviors which can lead to very serious health problems. Behaviors such as binging and purging and abuse of emetics, diuretics, or laxatives can cause serious complications, sometimes of a critical nature. Nurses must maintain a high index of suspicion for this disorder and use skillful assessment and intervention to prevent the critical multisystem complications of bulimia.

Eating disorders and adolescents: an overview of a maladaptive behavior.

TOPIC: Eating disorders among the adolescent population are a serious health problem. The author provides an overview of anorexia nervosa and bulimia nervosa. PURPOSE: To present information on eating disorders that includes DSM-IV criteria and typical profiles of the client. Current hypotheses about the etiology of eating disorders, medical complications, treatment approaches, morbidity and mortality data research, and outcome research of treatment are reviewed. Research, treatment, and educational considerations for nursing care are discussed. SOURCES: Published literature, clinical experience. CONCLUSIONS: Advanced practice nurses are particularly suited for working with adolescents because of their holistic approach to client care. Inconsistencies and gaps in the knowledge base of eating disorders regarding incidence, etiology, treatment approaches, pharmacology, and outcome are areas for future nursing research.

Bulimia nervosa. Associated physical problems.

1. Bulimia involves more serious problems than previously thought. Bulimia nervosa is a psychiatric disorder characterized by binge eating followed by some form of combination of purging, including laxative or diuretic use, strenuous exercise, and self-induced vomiting to eliminate unwanted calories. 2. Physical problems of bulimia include oral and neck problems, metabolic acid-base imbalances, volume depletion, hypochloremia, hypokalemia, hyponatremia, hypomagnesia, hypocalcemia, hyperuricemia, gastrointestinal problems, and edema. 3. The physical problems of bulimia are less well known than those of anorexia. Nurses must be alert for clues, act on suspicions, use a nonjudgmental approach, and be knowledgeable of all assessment factors, including psychological parameters.

Effective management of adolescents with anorexia and bulimia.

1. Anorexia and bulimia are common among adolescents, and both are complex, chronic disorders with high comorbidity and significant complications and mortality. 2. Eating disorders cultivate shame, denial, and lack of insight, making treatment difficult and necessitating careful development of a therapeutic alliance. 3. Treatment goals are to correct the biological and psychological sequelae, prevent or correct complications, restore normal eating patterns, reduce binging and purging, promote understanding and change in dysfunctional behaviors and attitudes, improve intrapersonal and interpersonal functioning, restore normal exercise patterns, and address comorbid psychopathology and psychological conflicts.

An introduction to anorexia nervosa and bulimia nervosa.

Nurses may come into contact with patients who have anorexia nervosa and bulimia nervosa. The authors discuss the signs and symptoms of these illnesses and outline treatment options for patients with eating disorders.